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Changes in Hematologic Markers in Patients with Mitral


Rewat Phankingthongkum MD*, Visanu Thamlikitkul MD*,
Decho Jakrapanichakul MD*, Sutiphol Udompanthurak MSc**
* Department of Medicine, Faculty of Medicine, Siriraj Hospital
** Office of Research Promotion, Faculty of Medicine, Siriraj Hospital, Mahidol University


Systemic embolism is a major complication of mitral stenosis which is usually related to a presence
of left atrial thrombus. Percutaneous balloon mitral valvuloplasty (PBMV) was previously reported to
reduce the incidence of this complication. However, the mechanisms of this beneficial procedure was under
investigated. The aim of this study was to investigate the changes in coagulation activity, platelet activity
and endocardial function in 29 patients with mitral stenosis after successful PBMV. All subjects had good
left ventricular systolic function and 48.3% had atrial fibrillation. There was a significant reduction in
thrombin-antithrombin complex (TAT) after a successful procedure and the level of thrombomodulin was
also significantly higher one month after successful procedure. However, the level of platelet factor 4 (PF4 )
and beta-thromboglobulin (-TG) were increased after this procedure but not achieved the statistical
In conclusion, successful PBMV can reduce the prethrombotic state in patients with mitral stenosis.
In addition, it may improve endocardial function of the left atrium in those without atrial fibrillation.

Keyword : Mitral stenosis, Balloon mitral valvuloplasty, Left atrial thrombus

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